NPIMap

Organization Active NPI

Sergeant Bluff Dental, PLLC

  • General Practice Dentistry
  • Sergeant Bluff, IA
National Provider Identifier
1497084115
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SERGEANT BLUFF DENTAL, PLLC
Practice address
703 1St St
Sergeant Bluff, IA 51054-8505
Phone
(712) 943-4242
Fax
(712) 943-4243
NPI assigned
Dec 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Renee Lynn Husen, D.D.S.
Title
Dentist
Phone
(712) 943-4242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

703 1St St
Sergeant Bluff, IA 51054-8505

Mailing address

703 1St St
PO Box 280
Sergeant Bluff, IA 51054-8505
Phone (712) 943-4242

National Provider Directory

National Provider Directory
Tax ID family
Sergeant Bluff Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1497084115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 1ST ST",
            "address_2": "PO BOX 280",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548505",
            "telephone_number": "712-943-4242",
            "fax_number": "712-943-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 1ST ST",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548505",
            "telephone_number": "712-943-4242",
            "fax_number": "712-943-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGEANT BLUFF DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "HUSEN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "712-943-4242",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sergeant Bluff, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.